Gear Up: A Surprise Diagnosis
“Hey, Dick, your colonoscopy went great.” So says my friend and expert colorectal surgeon. I am just coming out from the sweet embrace of Propofol, the magic elixir that killed Michael Jackson. Suffused with a sense of well-being, I look out over the sparkling waters of Tampa Bay lit by a warm December sun. My wife, Cathy, smiles.
“But I did feel a prostatic nodule. I looked back to my notes from five years ago, and there wasn’t a nodule then, so you should have it looked into.” Thus began an adventure into the maw of modern medicine and the workings of the FAA when it comes to a first-class medical certificate.
First, some basic prostate facts for our readers (ladies, this will take just a minute): About 239,000 men are diagnosed with prostate cancer every year in the United States, but only about 30,000 die of the disease. So we have a common disorder that infrequently kills patients. (Of course, given the age of men that are diagnosed with prostate cancer, many may die of others things. Death and taxes!) Since prostate cancer becomes more prevalent in men the older they get, there has been controversy about using the prostate-specific antigen (PSA) screening test. Is it possible that many men are treated to benefit the urologist or radiation therapist rather than the patient?
With all this in mind, I had a PSA test, and I was re-assured when it was normal. Because of the Christmas holidays, it was almost three weeks before I met with a careful, thoughtful urologist named Dr. David Hernandez. He examined me — this time I was awake — and recommended a biopsy. This was scheduled for a week hence.
A prostate biopsy is actually 12 different “passes” with a biopsy needle attached to an ultrasound head. The device looked innocent enough sitting on the counter in the biopsy room, but when it was inserted, it felt like I had the wrong end of a baseball bat shoved up there. Each time he fired the Louisville Slugger, I could feel it deep, deep down in the pelvis.
Another wait for results — almost two weeks. The news was not good; it was a cancer and not a trivial one. So much for the PSA test. For a cancer surgeon, this was an eerie, somewhat surreal experience. A cancer doctor catches cancer. Now I was on the other side of the knife.
I’ll leave out the description of searching for the right place and the right person to do the job. We settled on Dr. Vipul Patel of the Global Robotics Institute in Orlando, Florida. He and his team do a high volume of robotic prostatectomies, and I liked him immediately. He reassured me that he treats “a pilot a week,” so his team knew all about the magic words necessary to get my medical back.
Another wait of six weeks — once the prostate is disturbed by the biopsy, it needs to heal before you can schedule an operation. At 4 a.m. on a Monday in March, Cathy and I set out for Orlando. We were home fewer than 36 hours later. The physical recovery was surprisingly quick. The philosophical recovery was another matter. How do we all manage to take the extraordinary machinery whirring away flawlessly inside each of us for granted? Even though I had a professional awareness of this blithe ignorance, I found the concept to have even deeper meaning now that I had a bad cylinder.
If my life was to be shortened, did I want to continue as a cancer surgeon or did I want to do something else, such as fly airplanes? I know my father waited to retire from surgery until he was 71. He had always wanted to work in a hardware store, but by the time he retired, it wasn’t in the cards. At 67, could I get my medical back and do more flying? I had enjoyed the Lear 31A at Elite Air in St. Petersburg, Florida, immensely. Could I find a full-time flying job?
For that matter, when could I fly again? Was my first-class medical certificate still valid? I was feeling better and better. I went on the Internet to www.faa.gov. Within a few minutes, my head was uncomfortably rotating. After a good hour of searching I came upon the dreaded 61.53: “1. Operations that require a medical certificate. Except as provided in paragraph (b) of this section, a person who holds a current medical certificate issued under part 67 of this chapter shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember while that person:
a. Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or
b. Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.”